Systematic Literature Review Financial Incentives and Health Reporting Behavior in Primary Care

A Policy and Social Perspective

Abstract

Background: Healthcare provider’s reporting behavior is not merely a clinical task but is also shaped by social, institutional, and behavioral factors. In many low- and middle-income countries, under-reporting—particularly of diseases like tuberculosis—remains a major challenge due to the varying motivation and capacity of frontline healthcare providers. Objectives: This review aims to examine the influence of financial incentive strategies on the reporting behavior of healthcare providers in primary care settings. Methods: A systematic review was conducted, synthesizing evidence from 21 studies that explored the impact of financial incentives—particularly pay-for-performance schemes—on healthcare provider’s reporting behavior. Results: The analysis indicates that financial incentives can improve provider engagement and adherence to notification protocols. Pay-for-performance models were especially associated with increased compliance. However, the effectiveness of these strategies is context-dependent and influenced by factors such as provider trust, organizational infrastructure, policy coherence, and socio-cultural attitudes. The review also identified a tension between extrinsic motivators and intrinsic ethical responsibilities among providers. Conclusion: Financial incentive strategies can support improved reporting rate, but they must be designed with attention to the broader behavioral, institutional, and ethical context. Sustainable and socially responsive policy development should integrate both extrinsic and intrinsic motivators to foster long-term compliance and trust.